Nasopharyngeal Carcinoma

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What is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma (also known as NPC) is a rare tumor of the head and neck which originates in the nasopharynx. The nasopharynx is located at the very back of the nose near the Eustachian tubes (Figure). Nasopharyngeal carcinoma is more common in Southeast Asia and is frequently, but not always, caused by Epstein-Barr virus (EBV).

sagittal nasopharynx illustration

What are the symptoms of nasopharyngeal carcinoma?

  • Enlarged lymph node in the neck
  • Bleeding from the nose or mouth
  • Difficulty popping ears: This is due to close proximity of the tumor to the Eustachian tube, resulting in blockage and accumulation of fluid in the middle ear.
  • Difficulty breathing through the nose
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How is nasopharyngeal carcinoma diagnosed?

Nasopharyngeal carcinoma is diagnosed by biopsy of the tumor, which is often performed in clinic with a use of a small endoscope. This allows the head and neck surgeon to visualize the tumor and its extent. Imaging techniques (MRI and/or CT scan) may also help determine the extent of the tumor. Testing of the tumor for EBV is also recommended.

How is nasopharyngeal carcinoma treated?

Primary nasopharyngeal carcinoma (initial diagnosis) typically responds well to radiation therapy. Depending on the size and extent of the tumor, chemotherapy may be combined with radiation therapy.

Recurrent nasopharyngeal carcinoma (cancer that comes back after treatment), if manageable by surgical removal, can be removed either with an endoscope and endoscopic instruments through the nostrils or by an open surgical approach if necessary.

Sometimes radiation therapy, proton beam therapy, or chemotherapy are incorporated into the treatment of recurrent nasopharyngeal carcinoma. The use of immunotherapy for recurrent nasopharyngeal carcinoma patients is an active area of clinical research.

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